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Shock Wave Therapy - How Well Does it Work?

March 2, 2004 10:16 AM

By Jim Brown, Ph.D., Executive Editor, Sports Performance Journal

Although extracorporeal shock wave therapy (ESWT) has been approved by the FDA for treating heel pain (plantar fasciitis) and tennis elbow, it still remains a controversial procedure.

ESWT involves transmitting high-energy electric impulses into an affected area. It is believed that the scar tissue formed as a result of the microtrauma eventually results in increased circulation and healing. However, recent ESTW studies conducted in Australia and Europe (including one report in the British Medical Journal) have shown conflicting results.

Dr. John Ogden, an Atlanta orthopedic surgeon who supervised the clinical trials that led to FDA approval, spoke to the the editors early in January about the controversy.

"We are trying to dispel the notion that shock wave therapy is not effective for certain sports-related injuries," said Ogden. "The procedures used in Australia and Europe used different machines, different techniques, and low-energy impulses instead of the high-energy waves produced by the Ossatron (the machine used in U.S. clinical trials). During and since the initial testing, we have consistently produced success rates between 60 and 80 percent in treating plantar fasciitis and tennis elbow."

Ogden suggests that athletes who have not responded to conventional treatment methods talk with their sports medicine physicians about ESTW therapy as an option. In overuse injuries (which account for 65% of all sports injuries), there is seldom a single cause. The problem usually involves a part of the body "acting out" because of poor mechanics, unstable joints, mobility/flexibility deficits, or the failure of the athlete to understand how the parts of the body are linked to produce movement.

"It is also true that no single treatment, including extracorporeal shock wave therapy, is going to be the solution to tennis elbow or plantar fasciitis," says Athletes' Performance President Mark Verstegen.

Verstegen directs elite athlete training programs in Phoenix and Los Angeles. "An athlete could also take NSAIDs to get rid of the pain, but the problem would not be solved. "It's like putting a new set of tires on your car because one tire is showing wear, but not doing something about the alignment,"

While ESTW may be considered a treatment option, it is just one part of the solution. Any treatment should be a component in a multidisciplinary approach that includes stability, mobility, and flexibility training in order to prevent the injury from recurring.

© 2004 HMS Publishing, Inc.
Jim Brown will be contributing new content to this site on a monthly basis. If you have a question for Dr. Brown please feel free to email him at




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